Peb txhua tus tau hnov lo lus "shock," puas yog? Qee zaum peb xav tias nws yog lwm yam thaum peb ntshai lossis chim siab tam sim ntawd. Tab sis hauv kev kho mob, "shock" txhais tau tias yog ib qho mob hnyav dua. Hnub no peb yuav tham txog ib hom "shock" zoo sib xws, tab sis txawv me ntsis. Qhov no hu ua 'neurogenic shock.' Hais yooj yim, nws tshwm sim thaum muaj kev raug mob hnyav rau peb lub paj hlwb, tshwj xeeb tshaj yog cov hlab ntsha qaum .
'Neurogenic Shock' yog dab tsi tiag?
Xav txog koj lub paj hlwb zoo li lub xov tooj hauv ib lub tebchaws. Cov paj hlwb no nqa cov lus los ntawm lub hlwb mus rau txhua qhov ntawm lub cev. Tam sim no, thaum muaj kev raug mob rau lub paj hlwb no, tshwj xeeb tshaj yog rau cov hlab ntsha caj qaum, xws li pob txha caj qaum tawg lossis raug mob, lub cev uas nqa cov lus no yuav raug cuam tshuam.
Kev poob siab hauv lub hlwb yog ib qho mob uas koj lub plawv dhia, ntshav siab, thiab qhov kub ntawm lub cev tsis tuaj yeem tswj tau tom qab muaj xwm txheej. Ib yam li lwm hom kev poob siab, qhov no yog ib qho mob hnyav heev, thiab qee zaum tuaj yeem ua rau tuag taus. Qhov laj thawj rau qhov no yog tias cov ntshav ntws thoob plaws lub cev raug cuam tshuam. Thaum cov ntshav tsis ntws zoo, peb cov hlwb tsis tau txais cov pa oxygen thiab cov as-ham uas lawv xav tau. Tom qab ntawd cov hlwb tsis tuaj yeem ua lawv txoj haujlwm.
Yog li ntawd, nws yog ib qho tseem ceeb uas yuav tsum nrhiav kev kho mob rau qhov poob siab sai li sai tau.
Qhov txawv ntawm 'Neurogenic Shock' thiab 'Spinal Shock' yog dab tsi?
Txawm hais tias ob qho tib si muaj feem cuam tshuam nrog kev raug mob ntawm cov hlab ntsha hauv lub paj hlwb, tab sis muaj qhov sib txawv me ntsis. Hauv kev poob siab ntawm cov hlab ntsha hauv lub paj hlwb, koj cov leeg yuav ua rau lub cev tsis ua haujlwm thiab koj cov kev xav tsis zoo ploj mus tom qab raug mob rau koj cov hlab ntsha hauv lub paj hlwb. Hauv kev poob siab ntawm cov hlab ntsha hauv lub paj hlwb, cov teebmeem tseem ceeb yog rau koj lub plawv dhia thiab ntshav siab.
Qhov txawv ntawm 'Neurogenic Shock' thiab 'Hypovolemic Shock' yog dab tsi?
Kev poob siab vim tsis muaj dej txaus yog ib qho mob uas tshwm sim los ntawm kev poob dej ntau dhau, tshwj xeeb yog cov ntshav, ntawm lub cev. Qhov txawv tseem ceeb ntawm ob qho no yog lub plawv dhia.
- Ib tug neeg uas muaj kev poob siab ntawm lub paj hlwb (neurogenic shock ) muaj lub plawv dhia qeeb (bradyarrhythmia).
- Ib tug neeg uas muaj kev poob siab hypovolemic muaj lub plawv dhia ceev dua (tachycardia).
Leej twg raug tus mob no ntau tshaj? Nws tshwm sim ntau npaum li cas?
Kev poob siab ntawm lub paj hlwb tshwm sim rau cov neeg uas tau raug mob rau cov hlab ntsha qaum thiab ua rau lub paj hlwb puas tsuaj.
Kev tshawb fawb qhia tias ntawm 19% thiab 31% ntawm cov neeg uas tau raug mob ntawm tus txha caj qaum yuav muaj kevQhov no hu ua 'Neurogenic Shock'. Txawm tias nyob hauv lub tebchaws zoo li Asmeskas, muaj li ntawm 8,000 thiab 10,000 tus neeg raug mob pob txha caj qaum txhua xyoo. Cov laj thawj tseem ceeb ntawm qhov no yog kev sib tsoo tsheb thiab kev poob ntawm qhov siab. Cov xwm txheej zoo li no kuj muaj ntau hauv peb lub tebchaws thiab, puas yog?
'Neurogenic Shock' cuam tshuam li cas rau kuv lub cev?
Hais yooj yim xwb, thaum muaj kev raug mob rau cov hlab ntsha caj qaum, peb cov hlab ntsha tsis tuaj yeem xa cov cim mus rau cov hlab ntsha, hais tias, "Okay, tam sim no nqaim me ntsis." Thaum cov lus no tsis tau txais kom raug, cov hlab ntsha yuav loj dhau, uas hu ua 'vasodilation' . Nws zoo li lub yeeb nkab dej tam sim ntawd loj dua. Qhov tshwm sim yog tias cov ntshav siab tam sim ntawd poob qis 'hypotension' . Thaum cov ntshav siab poob qis, cov ntshav ntws thoob plaws lub cev kuj txo qis. Qhov no txhais tau tias peb cov kab mob tseem ceeb tsis tau txais cov pa oxygen uas lawv xav tau.
Cov tsos mob ntawm qhov no yog dab tsi?
Cov tsos mob ntawm kev poob siab neurogenic muaj xws li:
- Ntshav siab qis (Hypotension): Qhov no yog cov tsos mob tseem ceeb.
- Lub plawv dhia qeeb (Bradyarhythmia): Tus naj npawb ntawm cov neeg ntaus ib feeb feem ntau raug txo qis.
- Daim tawv nqaij yuav liab thiab kub, tom qab ntawd txias, tawm hws, thiab ntub dej.
- Daim di ncauj thiab cov rau tes tig xiav: Qhov no yog vim tsis muaj oxygen hauv cov ntshav.
- Tsis nco qab kiag li lossis tsis nco qab zoo: Qhov no tuaj yeem tshwm sim vim yog cov ntshav ntws mus rau lub hlwb tsawg dua.
Yog tias ib tug neeg muaj ib lossis ntau yam ntawm cov tsos mob no, tshwj xeeb tshaj yog tias lawv tau raug mob ntawm tus txha caj qaum, lawv yuav tsum tau txais kev saib xyuas tam sim ntawd.
Cov ua rau muaj 'Neurogenic Shock' yog dab tsi?
Muaj ntau yam tseem ceeb rau qhov xwm txheej no:
- Kev raug mob ntawm cov pob txha caj qaum: Qhov no yog qhov ua rau feem ntau tshwm sim. Nws tuaj yeem tshwm sim los ntawm tej yam xws li kev sib tsoo tsheb, kev poob ntawm qhov siab, lossis kev sib tsoo kis las.
- Cov tshuaj lom uas cuam tshuam rau lub paj hlwb autonomic.
- Guillain-Barré syndrome: Qhov no yog ib qho mob tsis tshua muaj uas cuam tshuam rau lub paj hlwb.
- Tshuaj loog rau pob txha caj qaum: Cov tshuaj loog no yog muab rau qee qhov kev phais. Nws tuaj yeem tshwm sim tsawg heev ua ib qho teeb meem.
- Transverse myelitis: Qhov no kuj yog kev kis kab mob ntawm cov hlab ntsha hauv cov hlab ntsha qaum.
Cov kws kho mob kuaj mob li cas?
Yuav kuaj xyuas seb koj puas muaj kev poob siab neurogenic, tus kws kho mob yuav ua cov hauv qab no:
1. Yuav kuaj koj lub cev: Yuav kuaj koj tus mob thiab qhov xwm txheej ntawm qhov raug mob.
2. Kev kuaj xyuas cov cim tseem ceeb: ntsuas ntshav siab, lub plawv dhia ceev, kev ua pa ceev, thiab qhov kub.
3. Kev kuaj ntshav tau ua tiav:Kawm txog lub xeev sab hauv ntawm lub cev thiab kev ua haujlwm ntawm cov kabmob.
4. Kev ntsuas raug txiav txim siab: Txhawm rau ntsuas qhov puas tsuaj rau tus txha nraub qaum kom raug.
Cov kev luam theej zoo li cas ua tiav?
Nov yog ob hom kev luam theej tseem ceeb:
- CT Scan (Computed Tomography - CT scan): Qhov no tuaj yeem pom tseeb qhov kev puas tsuaj rau cov pob txha.
- Kev thaij duab MRI (Magnetic Resonance Imaging - MRI scan): Qhov no tuaj yeem nrhiav tau qhov puas tsuaj rau cov nqaij mos ntawm tus txha nqaj qaum, uas yog, cov hlab ntsha thiab cov hlab ntsha.
Yuav kho tus mob Neurogenic Shock li cas?
Qhov no yog xwm txheej ceev hauv kev kho mob thiab kev kho mob yuav tsum pib tam sim ntawd.
Ua ntej, cov kws kho mob yuav muab ib daim ntaub qhwv caj dab rau koj lub caj dab. Qhov no yog los tiv thaiv kom cov hlab ntsha ntawm tus txha caj qaum tsis txhob mob zuj zus tuaj, vim tias kev txav koj lub caj dab tuaj yeem ua rau qhov raug mob hnyav zuj zus tuaj.
Tom ntej no, qhov tseem ceeb tshaj plaws yog tswj cov ntshav siab qis (hypotension). Qhov no yog ua los ntawm kev muab cov kua xws li saline los ntawm IV (intravenously).
Tom qab ntawd, muab tshuaj los tswj lub plawv dhia qeeb (bradyarrhythmia).
Thaum kho qhov 'Neurogenic Shock' no, koj kuj yuav raug kho rau lwm yam kev raug mob uas koj tau raug los ntawm qhov xwm txheej.
Cov tshuaj twg siv tau?
Cov kws kho mob yuav siv ntau hom tshuaj los tswj kev poob siab neurogenic:
- Phenylephrine
- Norepinephrine (Norepinephrine)
- Epinephrine
- Atropine
- Glycopyrrolate `(Glycopyrrolate)`
- Isoproterenol (Isoproterenol)
- Theophylline
- Aminophylline
Cov tshuaj no yog muab rau hauv qab kev saib xyuas nruj ntawm tus kws kho mob, suav nrog ntau yam xws li tus neeg mob tus mob, ntshav siab, thiab lub plawv dhia.
Puas muaj teeb meem lossis cov kev mob tshwm sim ntawm kev kho mob?
Txhua yam tshuaj muaj peev xwm ua rau muaj kev phiv. Tab sis cov kws kho mob tsuas yog xaiv cov tshuaj yog tias qhov txiaj ntsig rau tus neeg mob ntau dua li qhov kev pheej hmoo. Tsis tas li ntawd, yog tias cov kua dej uas muab los ntawm IV qee zaum siab dhau, muaj qhov tshwm sim me me uas lub cev yuav o.
Kuv yuav ua li cas thiaj txo tau qhov kev pheej hmoo no?
Vim tias qhov ua rau muaj kev poob siab ntawm lub paj hlwb yog kev raug mob ntawm cov hlab ntsha hauv lub hlwb, nws yog ib qho tseem ceeb uas yuav tsum tiv thaiv cov kev raug mob no. Muaj ntau yam uas koj tuaj yeem ua tau los pab:
- Tsis txhob tsav tsheb thaum haus dej cawv lossis siv yeeb tshuaj. Tsav tsheb kom zoo thiab xyuam xim.
- Yuav tsum hnav txoj siv sia thaum caij tsheb. Caij tsheb peb lub log thiab maus taus kom muaj kev nyab xeeb.
- Tsis txhob mus dhia dej rau hauv qhov chaw uas koj tsis paub lossis dej ntiav. Qhov no yuav ua rau raug mob caj dab loj heev.
- Ceev faj txog kev nyab xeeb thaum nce ntoo thiab ua haujlwm ntawm qhov siab.
Yog tias kuv muaj kev poob siab txog lub paj hlwb (neurogenic shock), kuv yuav tsum tau tos li cas?
Yog tias raug mob ntawm tus txha caj qaum ua rau muaj kev poob siab ntawm lub paj hlwb, cov ntshav qis (hypotension) tuaj yeem kav ntev txog tsib lub lis piam.
Tsis tas li ntawd xwb, lwm yam teeb meem kuj tuaj yeem tshwm sim nrog tus mob no. Piv txwv li:
- Cov ntshav txhaws hauv cov leeg ntawm ob txhais ceg (Deep Vein Thrombosis - DVT)
- Mob qhov txhab ntawm lub qhov txhab
- Kab mob ntsws los ntawm kev nqus pa yog tshwm sim los ntawm cov khoom noj lossis lwm yam khoom nkag mus rau hauv txoj hlab pa .
Kev poob siab neurogenic yuav kav ntev npaum li cas?
Feem ntau, cov tsos mob ntawm kev poob siab neurogenic tuaj yeem kav ntev li plaub txog tsib lub lis piam . Txawm li cas los xij, qhov no tuaj yeem txawv ntawm ib tus neeg mus rau ib tus neeg thiab nyob ntawm qhov xwm txheej ntawm qhov xwm txheej.
Kuv puas yuav rov qab mus ua haujlwm/kawm ntawv tau?
Seb koj puas rov qab mus ua koj tej dej num li qub, ua haujlwm, lossis kawm ntawv tau nyob ntawm seb koj qhov kev raug mob ntawm koj tus txha caj qaum hnyav npaum li cas thiab qhov xwm txheej ntawm lwm yam kev raug mob uas koj tau raug. Qee zaum koj yuav tsum tau hloov pauv loj rau koj lub neej, tshwj xeeb tshaj yog tias koj muaj teeb meem taug kev.
Yuav ua li cas thiaj pom tau tias muaj kev poob siab neurogenic?
Yog tias tsis kho, feem ntau cov mob poob siab yuav ua rau tuag taus. Txawm li cas los xij, kev kho mob sai thiab zoo tuaj yeem cawm koj txoj sia. Koj txoj kev noj qab haus huv yav tom ntej nyob ntawm ntau yam, suav nrog:
- koj lub hnub nyoog.
- Qhov hnyav ntawm qhov xwm txheej.
- Kev puas tsuaj rau lwm yam kabmob.
- Lwm yam kab mob uas koj muaj (lwm yam teeb meem kev kho mob).
- Siv sijhawm ntev npaum li cas los kho mob?
- Cov teeb meem ntxiv xws li tsis muaj peev xwm hais lus thiab poob qhov sib npaug.
- Koj lub cev teb li cas rau kev kho mob.
Tu siab kawg li, ib tug neeg uas raug mob rau ntawm tus txha caj qaum muaj feem yuav tuag ua ntej lub sijhawm ob mus rau tsib npaug ntau dua li ib tug neeg uas tsis tau raug mob. Qhov kev pheej hmoo ntawm kev tuag yog siab tshaj plaws hauv thawj xyoo tom qab raug mob rau ntawm tus txha caj qaum.
Kuv yuav saib xyuas kuv tus kheej li cas?
Yog koj raug mob rau cov hlab ntsha hauv koj lub cev, koj yuav muaj feem ntau dua rau lwm yam teeb meem kev noj qab haus huv, xws li Deep Vein Thrombosis (DVT), raws li tau hais ua ntej. Tsis tas li ntawd, kev poob siab rau lub hlwb, uas yog ib qho mob uas cov ntshav ntws tsawg dua thiab ib lossis ntau lub cev puas tsuaj.
Txhua tus neeg qhov teeb meem txawv, tab sis rau txhua tus neeg uas tau ntsib kev poob siab neurogenic, nws yog ib qho tseem ceeb uas yuav tsum ua raws li kev kho lub cev thiab cov lus qhia kho mob kom zoo kom tiv thaiv cov teeb meem yav tom ntej.
Kuv yuav tsum mus ntsib kuv tus kws kho mob thaum twg?
Yog koj pom muaj kev hloov pauv hauv koj tus mob, xws li kev hloov pauv ntawm cov cim qhia tseem ceeb lossis mob, koj yuav tsum qhia rau koj tus kws kho mob tam sim ntawd.
Kuv yuav tsum mus rau Chav Kho Mob Thaum Muaj Xwm Ceev (ETU) thaum twg?
Koj yuav tsum nrhiav kev kho mob thaum muaj xwm txheej ceev tam sim ntawd yog tias koj muaj cov tsos mob no:
- Mob hauv siab
- kiv taub hau
- Xeev siab
Cov no yuav yog cov tsos mob ntawm lwm yam mob hnyav.
Kuv yuav tsum nug kuv tus kws kho mob li cas?
Koj tuaj yeem nug cov lus nug ntawm tus kws kho mob zoo li no:
- Yuav ua li cas rau kuv qhov xwm txheej tshwj xeeb?
- Puas yog kuv cov kab mob puas tsuaj vim yog 'Neurogenic Shock'?
- Tej yam tseem ceeb tshaj plaws uas kuv yuav tsum ua yog dab tsi nyob rau hauv kuv qhov xwm txheej?
Cov Lus Qhia Luv Luv thiab Cov Lus Qhia Txog Kev Yuav Mus Tsev
Zoo, yog li 'Neurogenic Shock' uas peb tau tham txog hnub no yog ib qho mob txaus ntshai heev uas tuaj yeem tshwm sim los ntawm kev raug mob hnyav rau cov hlab ntsha qaum. Hauv qhov no, kev puas tsuaj rau lub paj hlwb ua rau lub cev tsis tswj hwm tej yam xws li lub plawv dhia thiab ntshav siab.
Qhov tseem ceeb tshaj plaws yog nyob kom muaj kev nyab xeeb li sai tau thiab sim zam kev raug mob rau koj tus txha nqaj qaum. Ceev faj heev thaum tsav tsheb, ua haujlwm ntawm qhov siab, thiab dhia mus rau hauv dej.
Yog tias muaj xwm txheej tshwm sim, nrhiav kev kho mob tam sim ntawd tuaj yeem pab cawm koj txoj sia. Tom qab ntawd, txuas ntxiv mus kho lub cev raws li koj tus kws kho mob qhia yuav pab koj kom noj qab haus huv li sai tau. Koj pab neeg kho mob yuav pab koj kov yeej qhov teeb meem no.
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Tsis muaj lus teb tau muab tso tawm. Ntxiv koj cov lus tawm ntawm no thawj zaug.
Ntxiv koj cov lus